EKG method for positioning PICCs


Intravenous literature: Pittiruti, M., Scoppettuolo, G., La Greca, A., Emoli, A., Brutti, A., Migliorini, I., Dolcetti, L., Taraschi, C. and De Pascale, G. (2008) The EKG Method for Positioning the Tip of PICCs: Results from Two Preliminary Studies. JAVA. 13(4), p.179-186.


Two preliminary studies were conducted to determine feasibility of using the electrocardiography (EKG) method to determine terminal tip location when inserting a peripherally inserted central catheter (PICC). This method uses the guidewire inside the catheter (or a column of saline contained in the catheter) as a intracavitary electrode. The reading on the EKG monitor reflects the closeness of the intracavitary electrode (the catheter tip) to the superior vena cava (SVC). The studies revealed that the EKG method was extremely precise; all tips placed using the EKG method has clear advantages in terms of accuracy, cost-effectiveness, and feasibility in conditions where x-ray control may be difficult or expensive to obtain. The method is quite simple, easy to learn and to teach, non-invasive, easy to reproduce, safe, and  apt to minimize malpositions due to failure of entering the SVC.

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